Mali Barbi: HER2+ Early Breast Cancer Had Its Biggest Two Weeks And ASCO Hasn’t Even Started
Mali Barbi/X

Mali Barbi: HER2+ Early Breast Cancer Had Its Biggest Two Weeks And ASCO Hasn’t Even Started

Mali Barbi, Medical Oncologist at Northwell Health, shared a post on X:

HER2+ early breast cancer just had its biggest two weeks – and ASCO hasn’t even started.

May 15: FDA approved TDXd for two indications in early-stage HER2+ disease. Neoadjuvant Stage II–III high-risk: DB11 ( pCR 67.3% vs 56.3% with ddAC-THP). Anthracyclines, finally challenged. Adjuvant over T-DM1 for residual disease: DB05 (3-year IDFS 92.4% vs 83.7%, HR 0.47).

T-DXd now owns every line of HER2+ BC. We are deep in the ADC era.

At ESMO Breast, SATEEN tested post-T-DXd sequencing. Sacituzumab + trastuzumab in HER2+ mBC after prior T-DXd. Stopped for futility.

TROP2-directed topo-1 ADC after HER2-directed topo-1 ADC -provisional answer: no.

Which makes LBA660 at ASCO 2026 worth watching critically. Neo Healer (KN026_004): anbenitamab, China-developed HER2 bispecific, no payload, no FDA approval, plus albumin-bound docetaxel vs TCbHP in early/locally advanced HER2+ BC. ~520 pts. Met tpCR endpoint. Full numbers at ASCO for the first time.

One molecule. Two non-overlapping HER2 epitopes. Signal blockade, receptor downregulation, enhanced ADCC. No ILD. No ADC toxicity. 6 cycles. Surgery ~6 weeks earlier than T-DXd -> THP.

Not the same population. DB11 replaced anthracyclines in high-risk disease. Neo-Healer replaced the dual antibody backbone in broader early/LA disease. Different questions.

Data compelling. Western regulatory path undefined. But the question is sharp: does a payload-free bispecific become the backbone you preserve – precisely to keep T-DXd available for residual disease rescue?

Watch LBA660. Critically.”

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